Q/ What is the aim of your studies at AIIMS?
A/ I have been working on the impact of yoga in complex lifestyle diseases since 2008, that is yoga as a mind-body energy medicine that targets the body as a whole. For example, depression, which is a disease of the mind, affects every cell of the body. People with depression have high stress levels and they tend to age faster. Similarly, complex lifestyle diseases are associated with co-morbid depression. We are working on the impact of yoga on sperm genome and sperm epigenome, and how it affects the health of future generations. It is proven from our study that yoga improves both nuclear and mitochondrial integrity and has positive impact on nuclear DNA (from both parents) and mitochondrial DNA (from the mother). Our studies on the impact of yoga on sperm genome are the first in the world.
Q/ How many participants have been included in the study?
A/ We are working on yoga and its impact on various diseases for the last 15 years. Since 2008, we have had more than 200 patients of glaucoma, more than 400 patients of unexplained male infertility, 150 patients of arthritis, 200 patients of depression, 120 patients of idiopathic recurrent spontaneous miscarriages and 45 patients of polycystic ovarian syndrome.
Q/ Can yoga be absorbed into integrative medicine to prevent diseases?
A/ Definitely, yoga should be integrated with modern medicine for management of complex lifestyle diseases. Yoga switches on the expression of genes that enhance DNA repair. It reduces oxidative stress (too many free radicals and not enough antioxidants to eliminate them, which leads to tissue damage) and inflammation. It increases telomerase (an enzyme that keeps cells from dying) activity and promotes neuroplasticity.
Q/ Your study says that yoga can be used as an adjunct therapy in the management of rheumatoid arthritis and co-morbid depression. How can asanas help physical and mental ailments?
A/ Yoga is not synonymous with asanas. It comprises of asana, pranayama and meditation. It is a mind-body energy medicine. Most people identify yoga with physical posture (asana). Having said that, maximum benefits come from regulated breathing practices (pranayama) and meditation (dhyana). They cause parasympathetic dominance―the system for rest, digestion and repair reduces stress and harmonises the mind and the body.
In rheumatoid arthritis, which is a severe, chronic, progressive inflammatory arthritis, yoga reduces inflaming. It reduces ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) levels (both inflammation indicators), maintains immune homeostasis, increases HLA-G (human leukocyte antigen-G) levels and thus induces molecular remission and re-establishes immunological tolerance in rheumatoid arthritis.
For mental ailments, our studies have shown yoga practices increase expression of genes that enhance neuroplasticity and genes that encode for neurotrophics factors (small proteins that support growth and survival of mature and developing neurons). Thus, yoga builds emotional resilience. It not only causes biochemical and physiological changes in brain but also anatomical changes. It increases grey matter in areas like prefrontal cortex, hippocampus and reduces size of amygdala, which is the centre for stress. Thus, yoga practices increase concentration, focus, attention, learning and memory.
Q/ Do you think yoga can help bring down the problem of infertility?
A/ There are many causes of infertility―they can be genetic causes like structural or numerical chromosomal defects, Y-chromosome deletions, anatomical causes, endocrine and immunological causes, which can lead to infertility in men. WHO reports have shown that in nearly half the infertility cases the problem is in the male. We have worked on cases with unexplained male factor infertility. In these cases, sperm count, motility, morphology and hormonal parameters are normal, yet they are infertile. Earlier studies from my lab have documented that the sperm is a cell most vulnerable to oxidative stress. Unhealthy lifestyle, smoking, excessive alcohol intake, excessive cellphone use, psychological stress and advanced age are associated with oxidative stress and oxidative damage to DNA and increase in concentration of oxidative DNA adducts (a form of DNA damage), which cause de-novo germline mutations. Oxidative stress damages both mitochondrial and nuclear genome. This results in not only infertility, but also in recurrent spontaneous miscarriage, congenital malformation, complex neuropsychiatric disorders and even childhood cancers. Practising yoga decreases oxidative stress and oxidative DNA damage and normalises levels of sperm transcripts. Yoga improves integrity of mitochondrial and nuclear genome and positively modulates the sperm epigenome, and this also impacts the lifelong health of the offspring.
Q/ What is the impact of yoga and meditation on other lifestyle diseases?
A/ Mediation focused on breathing decreases intraocular pressure (fluid pressure of the eye; IOP helps in evaluating patients at risk of glaucoma) and diurnal fluctuations in IOP. Meditation has a direct impact on trabecular meshwork gene expression (also related to the eye). An upward regulation of neuro-protective and downward regulation of pro-inflammatory genes was observed after pranayama and meditation. It leads to reduction in stress as seen by reduction in cortisol levels, and improves overall quality of life. Most benefits are observed with pranayam and dhyana that reduce stress hormone release by relaxation and harmonise mind-body relationship. From our studies, we have clearly seen that yoga can be used as an adjunct therapy in the management of complex lifestyle diseases. Yoga is a polypill. It modulates the epigenome and switches on gene programmes beneficial for health and wellness. If practised regularly, it can prevent onset of diseases and promote health.